Published Papers - Abstract 576

Schofield M, Powers J & Loxton L. Mortality and disability outcomes of self-reported elder abuse: A 12-year prospective investigation. Journal of the American Geriatric Society., 2013; 61(5): 679-685

Background/Objectives: Elder abuse is a challenging public health issue in need of more robust studies to identify abuse and examine health outcomes following abuse. This study aimed to determine whether elder abuse could predict mortality and disability over the ensuing 12 years. Design: Population-based prospective cohort study of women aged 70-75 in 1996; survival analysis.Setting: AustraliaParticipants: 12,066 women with complete data on elder abuseMeasurements: Elder abuse was assessed using the 12-item Vulnerability to Abuse Screening Scale (VASS) subscales: vulnerability, coercion, dependence, and dejection. Outcomes were death, and disability (defined as an affirmative response to ‘Do you regularly need help with daily tasks because of long-term illness, disability or frailty?’).Results: In 1996, 8% reported vulnerability, 6% coercion, 18% dependence and 22% dejection. By October 2008, 3488/12066 (29%) were deceased. Increased mortality was associated with coercion and dejection, after controlling for demographics, social support, and health behavior (hazard ratio (HR) and 95% confidence interval (CI) 1.21 (1.06; 1.40) and 1.12 (1.03; 1.23) respectively), but not after adding chronic conditions to the coercion model. Over the 12 years, disability was reported by 2158/11027 women who had reported no disability in 1996. Women who reported vulnerability or dejection were at increased risk of disability, after controlling for demographics, social support, and health behavior (HR and CI: 1.25 (1.06; 1.49) and 1.55 (1.38; 1.73) respectively). The hazard ratio remained significant for dejection when chronic conditions and mental health were included in the model (1.40 (CI 1.24; 1.58).Conclusion: This study found that specific components of vulnerability to elder abuse were differentially associated with higher rates of disability and mortality over the ensuing 12 years..